The aim of the study was to develop a conceptual model of drowning incidents. The authors conducted qualitative content analysis of drowning-incident videos (n = 41), and semi-structured interviews of those involved in drowning incidents (n = 34), followed by the measurement of frequencies and Boolean search with matrix intersection. Results confirmed that when there is human activity in, above, or around an aquatic environment, a drowning incident may occur to whomever, wherever, and under whatever circumstance. Factors that determined drowning outcome were, in order of importance, rescuer characteristics (Who1), casualty characteristics (Who2), location (Wherever), and general circumstances (Whatever). The interaction of the rescuer with the casualty largely determines the outcome of drowning. The 4W model is a promising tool in lifesaving and lifeguarding.